Wada Kenji, Nakashima Kenji
Division of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan.
Brain Nerve. 2012 Dec;64(12):1365-75.
Parkinson's disease (PD), a neurodegenerative disease, has been traditionally defined by its characteristic motor symptoms. Non-motor symptoms, including mood disorder, psychosis, sleep disturbance, autonomic dysfunction, and cognitive impairment, have being recently recognized as symptoms of PD. Cognitive impairment or dementia is one of the critical symptoms during the advanced stages of PD and is associated with increased disability and reduced quality of life of both patients and caregivers. The point prevalence of dementia in PD is about 30%, and its incidence rate in PD patients is 4-6 times higher than that in age-matched controls. The term mild cognitive impairment (MCI) has been adopted to describe the potential prodromal stage of dementia in PD, which has been gaining increasing attention. Several studies have reported the clinical features, epidemiology, biomarkers, and neuropathology of MCI in PD; however, neither the precise definitions nor the employed criteria were consistent across these studies. Recently, the Movement Disorder Society Task Force proposed new diagnostic criteria for MCI in PD to allow clinicians to identify PD patients with increased risk of dementia. Further studies are needed to validate the proposed criteria in daily clinical practice.
帕金森病(PD)是一种神经退行性疾病,传统上是根据其典型的运动症状来定义的。非运动症状,包括情绪障碍、精神病、睡眠障碍、自主神经功能障碍和认知障碍,最近已被确认为PD的症状。认知障碍或痴呆是PD晚期的关键症状之一,与患者和照顾者的残疾增加及生活质量下降有关。PD中痴呆的时点患病率约为30%,其在PD患者中的发病率比年龄匹配的对照组高4至6倍。术语轻度认知障碍(MCI)已被用于描述PD中痴呆的潜在前驱阶段,这一阶段越来越受到关注。几项研究报告了PD中MCI的临床特征、流行病学、生物标志物和神经病理学;然而,这些研究中既没有精确的定义,所采用的标准也不一致。最近,运动障碍协会特别工作组提出了PD中MCI的新诊断标准,以便临床医生识别痴呆风险增加的PD患者。需要进一步研究以在日常临床实践中验证所提出的标准。